title: [Fluoroscopic-guided primary single-step percutaneous gastrostomy: initial results using the Freka® GastroTube].
abstract: OBJECTIVE
  To determine the practicability and outcome of fluoroscopic-guided primary one-step treatment of percutaneous gastrostomy (PG) with the system Freka® Gastro Tube (Fresenius Kabi, Germany).
  
  
  METHODS
  In 39 patients (mean age 62.7 ± 12.0 years), primary PG was performed based on clinical indication from August 2009 to April 2010. The intervention was performed by an experienced radiologist under aseptic conditions by direct puncture with Freka® Gastro Tube under fluoroscopic guidance. The clinical data and outcome as well as any complications originated from the electronic archive of the University Medical Center Hamburg-Eppendorf.
  
  
  RESULTS
  The intervention was technically successful in all 39 patients. Within the mean follow-up time of 155.3 ± 73.6 days, 29 patients (74.4 %) did not experience complications. 10 patients (25.6 %) had to be revised. Complications manifested after a mean of 135.6 ± 61.2 days and mainly corresponded to accidental dislocation (50 %). One patient had to be surgically revised under suspicion of a malpositioned tube and suspected intestinal perforation. Clinically relevant wound infections were not detected. The total costs per patient were 553.17 € for our single-step treatment (OPS 5 - 431.x) vs. 963.69 € (OPS 5 - 431.x and OPS 8 - 123.0) for the recommended two-step treatment.
  
  
  CONCLUSIONS
  Fluoroscopic-guided primary single-step treatment with Freka® Gastro Tube system is feasible and not associated with an increased complication rate when compared to published literature applying a two-step treatment approach. Material costs as well as human and time resources could be significantly reduced using the single-step treatment.
authors.affiliation: Zentrum für Radiologie und Endoskopie, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
authors.forename: J D
authors.initials: JD
authors.lastname: Hahne
authors.forename: B P
authors.initials: BP
authors.lastname: Schönnagel
authors.forename: C
authors.initials: C
authors.lastname: Arndt
authors.forename: J
authors.initials: J
authors.lastname: Herrmann
authors.forename: P
authors.initials: P
authors.lastname: Bannas
authors.forename: A
authors.initials: A
authors.lastname: Koops
authors.forename: G
authors.initials: G
authors.lastname: Adam
authors.forename: C R
authors.initials: CR
authors.lastname: Habermann
mesh_terms: D000368:Aged; D002408:Catheters, Indwelling / Q000191:economics; D003365:Costs and Cost Analysis; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy / Q000191:economics / Q000295:instrumentation*; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000191:economics / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000295:instrumentation*; D009313:National Health Programs / Q000191:economics; D012086:Reoperation / Q000191:economics